Trends and regional disparities in maternal hypertensive disorders among women of childbearing age: a global burden of disease analysis from 1990 to 2021

• Published in: BMC pregnancy and childbirth Vol. 25; no. 1; pp. 812 - 17
• Main Authors: Wang, Jiayu, Wang, Jingxuan, Guan, Yu, Liang, Jia, Tang, Dongdong, Yin, Tailang, Diao, Lianghui
• Format: Journal Article
• Language: English
• Published: England BioMed Central 06.08.2025; BMC
• Subjects: Age groups; Chronic illnesses; Decomposition; Diabetes; Disease; Global burden of disease; Health disparities; High income; Hypertension; Inequality; Low- and middle-income countries; Maternal health; Maternal hypertension; Mortality; Population; Preeclampsia; Pregnancy; Public health; Regions; Regression analysis; Trends; Womens health; Maternal hypertension; Low- and middle-income countries; Global burden of disease; Maternal health; Preeclampsia; Health disparities
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-025-07926-0

Section BackgroundMaternal hypertensive Disorders (MHD), including gestational hypertension, preeclampsia, and eclampsia, remain a major contributor to maternal and neonatal morbidity and mortality worldwide. While global healthcare advancements have improved maternal survival, the incidence of MHD continues to rise, particularly in low- and middle-income countries (LMICs).AbstractSection ObjectiveThis study aimed to comprehensively assess the global and regional trends in the burden of MHD among women aged 15–49 years from 1990 to 2021 using data from the Global Burden of Disease (GBD) 2021 study. We examined disparities across countries and Socio-Demographic Index (SDI) regions, analyzed the influence of demographic and epidemiological factors through decomposition analysis, and projected future trends in MHD burden through 2050 using a Bayesian age-period-cohort (BAPC) model.AbstractSection MethodsWe extracted incidence, mortality, and disability-adjusted life years (DALYs) of women aged 15–49 years from the GBD 2021 database across 204 countries. Temporal trends were analyzed using Joinpoint regression and the estimated annual percentage change (EAPC). Socioeconomic disparities were evaluated using the SDI, and future projections were conducted using a BAPC model with sensitivity analysis.AbstractSection ResultsThe global MHD mortality (AAPC: -2.16%; 95% CI: -2.1 to -2.21) and incidence (AAPC: -0.5%, 95% CI: -0.45% to -0.56%) rate has declined. Decomposition analysis revealed that population growth and epidemiological changes were the main drivers of the increasing incidence, while aging had a less pronounced effect. Health inequality analysis demonstrated a clear negative correlation between MHD burden and socioeconomic development, highlighting the disproportionate impact on disadvantaged populations.AbstractSection ConclusionThe global burden of MHD exhibits significant regional disparities, with an declined trend in incidence. To address this persistent challenge, targeted interventions focusing on strengthening healthcare systems, improving access to quality obstetric care, and addressing socioeconomic inequities are urgently needed.